What Does a Dialysis Nurse Do?

Thanks to the amazing medical procedure known as dialysis, people with renal failure can now live full and robust lives. Dialysis nurses use their expertise in kidney disease and treatment to make each dialysis session safe, efficient and effective. This professional is the lifeline for anyone who undergoes this complex procedure.

Dialysis nurses are experts in all types of dialysis, including hemodialysis (in which a machine is used to clean the blood) and peritoneal dialysis (in which a special fluid is injected into the person’s abdominal cavity to absorb toxins). Regardless of the type of dialysis, these nurses carefully monitor the patient’s condition before, during and after the procedure and consult with physicians and technicians as needed. Because kidney disease is complex, dialysis nurses work closely with professionals from many disciplines, including physicians, dietitians, social workers and technicians. They also help patients understand their illness and treatment options and show them how to manage their disease through self-care and medication.

After a kidney transplant, a patient continues to work with a dialysis nurse while adjusting to the new kidney. The nurse watches for signs of infection or organ rejection and prepares a patient to care for himself safely at home. Many dialysis nurses follow up with their former patients to see how they are doing and to make sure they are taking needed medications.

Just as there are different types of dialysis, and many different scenarios in which patients require this form of live-saving intervention, there are also a variety of nursing roles in dialysis medicine. An acute dialysis nurse works with patients who are critically ill and hospitalized, often with illnesses that affect several body systems simultaneously; these acute-care nurses are licensed RNs or hold more advanced credentials. Chronic dialysis nurses work in hospital units, outpatient facilities, and even in patients’ homes, assisting adults and children for whom dialysis is a routine or daily part of life; these nurses may be RNs, advanced practice RNs, or LPNs/LVNs (depending on the state and facility). All dialysis nurses are experts who must cope with frequent unexpected problems, but acute dialysis nursing requires a strong independent judgment and a high tolerance for adrenaline.

For compassionate people with excellent analytical skills, a career as a dialysis nurse is extremely rewarding. Dialysis nurses see their patients several times a week and often develop close relationships with them. They have the satisfaction of boosting the morale and quality of life for individuals and families facing a serious illness.

Workplace Details

Dialysis nurses work in many settings, including:

Hospitals

Outpatient treatment centers

Transplant programs

Home health care agencies

Hospice and palliative care services

Nursing homes and long-term care facilities

The schedules of dialysis nurses vary. Nurses working in outpatient clinics are more likely to have regular business hours with occasional evening or weekend appointments. In hospitals, nurses work rotating shifts that include evenings, weekends and holidays. Dialysis nurses who provide in-home care generally schedule around the needs of the patient. In 2014, about 1 in 6 registered nurses (including dialysis nurses) worked part time.

Most dialysis nurses work in clean, well-lit clinical settings, though some also travel to patients’ homes.

Dialysis nurses have frequent contact with hazardous substances, including needles, blood and other bodily fluids. They follow strict safety precautions to prevent injury and infection.

Salary and Job Outlook

State

Average Wage

California

$101750

Texas

$70390

New York

$80830

Florida

$64630

Pennsylvania

$68770

Hover over any state to explore local income and job growth data.

Created with Raphaël 2.1.0ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

According to the US Bureau of Labor Statistics, the annual median income for registered nurses (including dialysis nurses) is $67,490. The lowest paid 10% earn roughly $46,360, and the highest paid 10% earn close to $101,630.

Dialysis nurses who are RNs can increase their earning potential by completing an advanced degree, holding a specialty certification or working in a supervisory role. Dialysis nurses who work in outpatient care facilities and hospitals usually earn more than their counterparts in private doctors’ offices.

Employment of registered nurses (including dialysis nurses) is expected to grow by 16% between 2014 and 2024, according to the US Bureau of Labor Statistics. This above-average growth is largely due to the aging of the baby boomer generation, which is expected to increase the demand for all types of healthcare services in the next few decades. Because older people are more likely to suffer from kidney failure, the number of people undergoing dialysis is expected to rise.

Demand will be greatest for dialysis nurses who:

Are nationally certified

Hold an advanced degree

Specialize in a key clinical area (for example, transplants)

Are willing to relocate

Compare Salaries by City

10th Percentile

50th Percentile

90th Percentile

New York City NY Median Pay

$86520 Per Year

$41.59 Per Hour

Los Angeles CA Median Pay

$95940 Per Year

$46.12 Per Hour

Steps to Become a Dialysis Nurse

1

Earn either a practical nursing diploma, an associate degree or bachelor's degree in nursing from an accredited school.

Nurses who wish to specialize in dialysis care must be certified as registered nurses (RNs) or advanced practice nurses.

If practical or vocational nursing is your goal, then the first step is to attend a 1-year non-degree program.

The first step towards becoming an RN is to earn an associate or bachelor’s degree in nursing. Training takes two to four years and includes hands-on work in many areas of nursing. In addition to their core coursework, aspiring dialysis nurses build their knowledge base through courses in nephrology, pharmacology and nutrition. They should also gain as much clinical experience as possible caring for dialysis patients. Newly certified RNs may find a new nurse residency program to make the transition to practice smoother.

Become certified in your state and pass the NCLEX.

Nurses must be certified before practicing in all 50 states and the District of Columbia. This requires completion of a state-approved training program and a passing score on the National Council Licensure Examination (NCLEX).

After graduating from their educational program, aspiring RNs pass the NCLEX-RN exam, while practical/vocational nurse must pass the NCLEX-PN exam.

3

Earn a master's or doctorate degree in nursing.

To become an advanced practice nurse, RNs must first earn a bachelor’s degree, if they haven’t already done so. They then complete two to five years of additional study to earn a master’s degree or doctorate in nursing, either of which allows them to pursue certification as advanced practice nurses. This allows them to serve as primary care providers of people with kidney disease. In many states, advanced practice nurses write prescriptions and perform many of the same functions as a physician.

4

Consider pursuing certification as a nephrology nurse.

If you are an RN, LPN/LVN, or NP (nurse practitioner) working in nephrology, or in dialysis specifically, you can pursue voluntary certification as a Certified Nephrology Nurse (CNN) through the Nephrology Nursing Certification Commission. The credential requires 2,000 hours of recent experience (at minimum) and also a varying number of hours of documented professional development in the field. To earn the credential, candidates must pass an exam.

5

Maintain licensure in your state.

Some states require CEU (continuing education units) to be completed and others require a minimum number of hours worked to maintain licensure as a registered nurse. Check the requirements in your state through your State Board of Nursing.

6

Look into opportunities for advancement.

Experienced dialysis nurses often specialize in the care of certain populations such as pediatric, adult or elderly patients. Others build their expertise in a clinical area such as transplantation, continuous renal replacement therapy or palliative care.

Dialysis nurses may be promoted to supervisory positions such as a nurse manager, organ recovery coordinator or transplant coordinator. Others leave the clinical setting to enter teaching, conduct research or serve as consultants to the healthcare, medical equipment and pharmaceutical industries.

Some experienced dialysis nurses transition into nephrology case management. In this role, they provide patient advocacy and ensure continuity of care for patients living with kidney disease.

Keeping up with new developments in your field is always a challenge for working professionals. The American Nephrology Nurses’ Association (ANNA) provides an online guide to continuing education opportunities, conferences, and a library of publications for nephrology nurses.

Explore Academic Paths

Students who graduate with bachelor’s or associate degrees in nursing are eligible to become licensed RNs, while students who earn practical nursing or vocational nursing (PN/VN) degrees can obtain the LPN/LVN licensure. Any nursing school or nursing program website should clearly advertise its accreditation status. Look for accreditation by the CCNE (Collegiate Council of Nursing Education) or ACEN (Accreditation Commission for Education in Nursing). If you’re uncertain about the current status of a program, check with your state’s nursing board or nursing commission. Your future job prospects hinge on whether you graduated from a nationally accredited nursing program.

DIPLOMA/CERTIFICATE PROGRAM

1-2 years initial study

A practical/vocational nursing diploma or certificate allows students to quickly enter the field of healthcare and work with patients in non-acute settings, such as long-term care facilities, neighborhood health/outpatient clinics, and home care; some hospitals also employ LPNs. PN educational programs are offered at technical and community colleges on a part-time and full-time basis. Earning a PN qualifies students to sit for the LPN-NCLEX.

To become a practical nurse, you’ll need to develop clinical skills, learn to communicate effectively with patients, and broaden your understanding of human biology. Your PN studies may include courses like:

Foundations of nursing

The classroom portion of a course that teaches core concepts and skills of practical nursing, including therapeutic communication.

Clinical skills lab

This allows you to practice your foundational classroom knowledge with supervision and feedback from your instructor.

Patient assessment

Here’s where you’ll learn to correctly take a patient’s history and critically assess his/her current state of health.

Gerontology

The study of physical and psychological changes that occur as part of the human aging process.

Principles and practice of intravenous therapy

Provides the student with practical knowledge needed to initiate and monitor IV therapies.

ASSOCIATE DEGREE

2-3 years initial study

Technical and community colleges offer ADN/ASN programs, often serving students who are starting their second careers. Earning an associate degree prepares you to qualify as an RN and work in acute care (hospital) settings.

Associate degree programs are not interchangeable: if you do your research, you’ll find that schools offer different courses, and even standard courses may be taught in a variety of ways, including non-traditional classroom models. Take the time to locate a program that appeals to your interests. If you’re aiming to gain experience in dialysis, it’s a good idea to choose a school that’s not far from hospitals with well-regarded renal/nephrology units, since small colleges tend to place students at local hospitals for their clinical training.

Some of the courses you can expect include:

Principles of nursing (2+ semesters)

A course in the basic skills of nursing, with an emphasis on safe practice.

Nursing care of the acute patient

A course in hospital nursing, with practicum.

Care of the mental health patient

Students learn how to assess and care for patients suffering from mental illness.

Nursing care across the lifespan

Students consider issues surrounding the provision of care to patients at all life stages, from childhood through adulthood and senescence.

BACHELOR'S DEGREE IN NURSING

4 years

A bachelor’s (baccalaureate) degree program is designed to prepare students for hospital work and also for advanced nursing studies. The BSN (Bachelor of Science in Nursing) curriculum requires students to develop their writing abilities and become well-rounded students of the human condition, exploring history and the social sciences. Students take a number of math and life science classes in the first two years of study to pave the way for nursing specialty courses.

Your coursework will likely include:

Nursing practice (2+ semesters, with clinical practicum)

Students learn and apply basic clinical techniques.

Microbiology (with laboratory)

A course introducing the biology of viruses and bacteria, and the crucial roles these organisms play in human health.

Nursing adults with acute and chronic illness

A nursing course that addresses safe and effective care of teens and adults coping with serious illness.

Lifespan development

Students examine the process of human development from conception through senescence.

A bachelor’s or graduate degree in a non-nursing field may qualify you to enroll in an accelerated BSN (ABSN) degree programs, rather than a traditional four-year program. Your eligibility for an ABSN program depends on your previous grades, and whether your prior degree program meets science and math prerequisites for nursing study.

MASTER'S OR DOCTORAL DEGREE

2 years, MSN, full-time; 2.5-3 years, DNP, full-time

If your experience as a staff nurse motivates you to seek out a leadership role in your workplace – for instance, supervising or teaching other nursing professionals – you should consider attending graduate school in nursing. Nurses who have earned their master’s or doctoral degree in nursing can become credentialed as nurse practitioners (NP), nurse anesthetists, or other advanced-practice specialists. Digging deeper into your nursing practice can pave the way for career advancement into leadership and education, and also allow you to broaden your scope of practice. Nursing graduate programs accept BSN-RNs; other admission requirements vary depending on the advanced practice area you want to study.

In addition to their program-specific coursework, most APRNs will take courses that include:

Leadership for health professionals

Students learn communication and management techniques that prepare them to supervise a team of nurses and staff.

Advanced health assessment

Students get feedback on their exam technique and improve their diagnostic skills.

Advanced pathophysiology

A course that examines how diseases (pathologies) are produced by disruptions in healthy physiology (the body’s self-regulatory processes).

Advanced pharmacology

How drugs work on different tissues and organs in the human body. Students enlarge their prescriptive knowledge of medications.

Keys to Success as a Dialysis Nurse

Necessary Skills and Qualities

Kind

Their natural empathy and compassion helps dialysis nurses to motivate their patients to stick with treatment and make necessary changes.

Team player

Dialysis nurses rely on their excellent interpersonal skills when working with patients and other professionals. They need to work well with people from many different disciplines.

Mentally and emotionally stable

Because they work long hours around very sick patients, dialysis nurses need excellent self-management skills. They must be emotionally mature and stable in order to support suffering patients without becoming overwhelmed themselves. To protect their own well-being, nurses should also practice good self-care, including exercise, nutrition, rest and additional support when needed.

Detail-oriented

Many dialysis patients suffer from additional chronic conditions, including heart disease, diabetes, high blood pressure and drug addiction. Dialysis nurses rely on their attention to detail and strong analytical skills in order to manage several conditions safely at once. This is especially true in the area of medication safety.

Physically strong

Hospital nurses spend most of the workday on their feet and frequently bend, stoop and stretch. These professionals must be strong enough to lift and move patients.

Popular Degree Programs

Related Career Paths

Authored by:

Holli Sowerby, EdD, RN

Holli Sowerby EdD, RN is an assistant professor of nursing at Weber State University. Her research interests include the perceptions of graduates regarding laboratory simulation experiences and the effectiveness of simulation.